The Kenya Medical Supplies Authority (KEMSA) is at the center of a financial crisis, with senators calling for urgent reforms to address its inefficiencies. The agency, responsible for supplying essential medicines to public health facilities, is struggling under a debt burden of Ksh6.2 billion, largely due to unpaid bills by county governments.
Senators argue that KEMSA’s current structure as a state agency is ineffective, given that its primary clients are county governments. They propose transforming KEMSA into an inter-county authority, which they believe will improve efficiency and ensure a more sustainable supply of medicines.
Nominated Senator Catherine Mumma emphasized the urgency of restructuring, stating, “Time has come for KEMSA to be restructured and made an inter-county authority.” She and other lawmakers believe that such a shift would enhance accountability and financial sustainability.
Narok Senator Ledama Olekina has also proposed a new payment model to prevent the accumulation of unpaid bills. According to him, pharmaceutical manufacturers registered with KEMSA should only release medicines upon immediate payment by counties.
“This will help tackle the twin problems of expired drugs and unpaid bills. Since county governments struggle to clear their debts, why don’t we create a system where manufacturers release drugs only when prescribed and payment is made? It is not right for patients to go without medicine just because counties have not paid KEMSA,” he stated.
Health Cabinet Secretary Deborah Barasa acknowledged the crisis while appearing before the Senate. She attributed KEMSA’s financial constraints to inadequate budget allocations and delayed payments from county governments and other clients.
“Drug availability is one of the biggest challenges we face,” Barasa said, assuring lawmakers that the government is implementing reforms to stabilize the agency. She mentioned that recapitalization efforts are underway, with additional resources being allocated to KEMSA to ensure a steady supply of essential medicines.
Despite these assurances, KEMSA’s financial woes continue to escalate. As of May last year, county governments owed the agency Ksh3.03 billion, with Ksh2.08 billion being overdue for more than 90 days. The largest debtor is Nairobi County, which owes Ksh235 million, followed by Homa Bay (Ksh104 million), Kakamega (Ksh66 million), and Taita Taveta, which also has outstanding payments.
KEMSA’s challenges are not new. The agency has been plagued by allegations of corruption, mismanagement, and inefficiencies in procurement and distribution. A recent audit revealed stockouts of essential medicines, with some reports indicating that expired drugs were still in circulation. Additionally, the agency has faced scrutiny over financial mismanagement, including overpayments and irregular procurement processes.
In previous years, KEMSA has sought financial bailouts from the government to restock medical supplies. In 2023, the agency requested Ksh5 billion to address cash flow challenges. However, the lack of a sustainable operational model has led to repeated financial instability, raising concerns about the future of public healthcare supply chains in Kenya.
Experts suggest that transforming KEMSA into an inter-county authority could bring greater efficiency, allowing counties to have a direct stake in its operations. Additionally, implementing a payment-before-supply system could help mitigate financial risks and ensure a steady supply of medicines to public hospitals.
Lawmakers also recommend stricter financial management practices and increased oversight to prevent corruption and wastage. Strengthening partnerships with private sector players could also help improve supply chain efficiency and enhance service delivery.
As discussions on KEMSA’s restructuring continue, the pressing concern remains ensuring that hospitals do not run out of essential drugs. Patients, especially those in remote areas, are the most affected by stockouts, making it imperative for both the government and county administrations to find a lasting solution.
Without decisive action, KEMSA’s debt crisis could further cripple Kenya’s public healthcare system, leaving millions without access to life-saving medications.
